Abstract
BACKGROUND: Bupropion is associated with a dose-related increased seizure risk. This effect could correlate with a change in motor cortex excitability. Transcranial magnetic stimulation (TMS) can assess changes in motor cortical excitability by measuring resting motor threshold (RMT). METHODS: RMT was determined before and during 2 weeks concomitant administration of bupropion at two different doses (150 mg/d and 300 mg/d) in a 41-year-old woman enrolled in a study of repetitive TMS (rTMS) for the treatment of depression. RESULTS: RMT was significantly lower when the patient took 300 mg/d of bupropion compared with no bupropion and 150 mg/d of bupropion. When bupropion was reduced to 150 mg, RMT returned to the premedication level. CONCLUSIONS: Bupropion 300 mg/d increased cortical excitability as demonstrated by decreased RMT. This finding emphasizes the importance of assessing RMT regularly during rTMS treatment, especially in the context of new or changed doses of medications.